Doctors criticize board’s decision and its process

The current falling out between Haywood Regional Medical Center and the ER doctors is a symptom of a larger problem afoot, according to physicians who appealed to the hospital board on behalf of the medical community last week.

The doctors selected by the medical community to share their concerns with the hospital board said the current ER conflict is a result of poor communication between the hospital board and medical community. They said physicians feel excluded and walled out and asked for a more direct line of communication with the board.

At a countywide meeting of doctors earlier this month, doctors voted 50 to 2 to ask the hospital board to reconsider their decision to terminate the hospital’s contract with the current ER group and undergo mediation.

“You can and should trust the medical staff when it speaks out,” Dr. Henry Nathan said to the board. “This particular issue has caused the medical staff to speak out loudly and with a huge majority. We rarely feel the need to interject our opinions on the board. When we do please take note. It is probably important. Please listen to us.”

The medical community has expressed concerns over the impact the decision will have on recruiting new doctors to the community. Doctors won’t want to come here if the hospital administration is seen as hostile toward doctors and hard to work with.

“There is a shortage of primary care physicians. It is unclear why the board would wish to dismiss physicians that are providing quality care and who want to stay,” Nathan said. “We are losing physicians as it is, despite our efforts to convince them to stay, because of difficulty for them to achieve personal and professional satisfaction here in Haywood County. Our focus should be on physician recruitment and physician retention, not physician rejection.”

The current ER doctors have proven their dedication to the community, he said.

“They have provided quality care in our community for many years. They have worked for years to expand and improve the service in the emergency department,” Nathan said. “To be asked to leave, to be fired, is quite traumatic.”

The meeting was the second time physicians attempted to appeal to the hospital board. A large coalition of doctors asked meet with the hospital board in November, but were thwarted from doing so. Since the hospital board is a public body, meetings must be announced 48 hours in advance to comply with the state open meetings law. But the hospital administration forgot to announce the meeting. A few hours before the meeting, hospital CEO David Rice told some board members not to show up so it wouldn’t count as a full meeting of the board. When a coalition of 45 doctors showed up at the meeting, they were disappointed to find only three hospital board members had come.

“That was very upsetting to the medical staff,” Dr. John Stringfield told the board. “At that point of the timeline, they felt their input into this process was critical and a presentation to the entire board would have been much more effective at conveying our concerns. A lot of physicians were very upset about how this situation seemed to be unraveling.”

It is unclear how the medical community will react now.

“This decision has proceeded even in face of overwhelming medical staff opposition to it,” Stringfield told the board. “A great issue is how does this affect the future relationship between the medical staff and the board.”

Dr. Benny Sharpton told the hospital board it should have realized this decision would be emotional and done more to communicate with the medical community about it earlier in the process. As a result, trust between the medical community and hospital administration has been violated, Sharpton said.

Dr. Nancy Freeman, chairman of the HRMC board, addressed this concern at the end of the meeting.

Freeman almost forgot to mention this pledge, however. Freeman was about to conclude the meeting for a recess when hospital board member Mark Clasby leaned over and prompted her to make the communications pledge.

Dr. Richard Steele, a hospital board member, said that the 50 to 2 vote at a countywide meeting of doctors three weeks ago was misleading. It was not done by secret ballot, but instead a show of hands. Some doctors felt if they went against the majority they would suffer from the loss of referrals by other doctors, he said.

The majority in the medical community, however, has lauded the quality of care, reputation and standing of the current ER doctors.

“We would not be here talking to you if we didn’t feel strongly and we weren’t extremely concerned with what has been happening,” Nathan said.